血清CEA、NSE、ProgRP、CYFRA21⁃1在孤立性肺结节中的变化及影响因素分析

Changes and influencing factors of serum CEA,NSE,ProgRP,and CYFRA21⁃1 in solitary pulmonary nodules

目的分析血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、胃泌素释放肽(ProgRP)、细胞角蛋白⁃19的可溶性片段(CYFRA21⁃1)在孤立性肺结节(SPN)中的变化及影响。方法选择2020年1月至2022年10月安徽医科大学附属巢湖医院胸外科收治的90例SPN患者作为研究对象,均行胸腔镜手术切除术,根据术中病理结果分为恶性组、良性组。患者入院时均接受血清CEA、NSE、ProgRP、CYFRA21⁃1、SPN检测;统计并比较患者基线资料。结果恶性组结节形态为不规则形患者占比高于良性组,结节直径长于良性组,入院时血清CEA、NSE、ProgRP、CYFRA21⁃1高于良性组,差异有统计学意义(P<0.05);建立二元Logistic回归模型,结果显示,结节形态为不规则形,结节直径长,血清CEA、NSE、ProgRP、CYFRA21⁃1呈高表达是SPN恶性病变的危险因素(OR>1,P<0.05);绘制ROC曲线结果显示,入院时CEA、NSE、ProgRP、CYFRA21⁃1及联合检测诊断恶性SPN的AUC均>0.70,预测价值较理想;出院1个月、出院3个月、出院6个月时,血清CEA、NSE、ProgRP、CYFRA21⁃1低于入院时,并呈下降趋势,差异有统计学意义(P<0.05)。结论血清CEA、NSE、ProgRP、CYFRA21⁃1与SPN恶性病变关系密切,同时可有效诊断恶性SPN。

Objective To analyze the changes and effects of serum carcinoembryonic antigen(CEA),neuron⁃specific enolase(NSE),gastrin⁃releasing peptide(ProgRP)and cytokeratin⁃19 soluble fragment(CYFRA21⁃1)in solitary pulmonary nodules(SPN).Methods A total of 90 patients with SPN admitted to the Department of Thoracic Surgery,Chaohu Hospital Affiliated to Anhui Medical University from January 2020 to October 2022 were selected as the research objects.All patients underwent thoracoscopic surgery and were divided into the malignant group and the benign group according to the intraoperative pathological results.All patients were tested for serum CEA,NSE,ProgRP,CYFRA21⁃1 and SPN detection at admission.The baseline data of patients were counted and compared.The relationship between serum CEA,NSE,ProgRP,CYFRA21⁃1 levels and SPN was analyzed by binary Logistic regression.Results The proportion of patients with irregular nodules in the malignant group was higher than that in the benign group,the diameter of nodules was longer than that in the benign group,and the serum CEA,NSE,ProgRP and CYFRA21⁃1 at admission were higher than those in the benign group.The difference was statistically significant(P<0.05).Binary Logistic regression model was established.The results showed that irregular nodule shape,long nodule diameter,and high expression of serum CEA,NSE,ProgRP and CYFRA21⁃1 were risk factors for SPN malignant lesions(OR>1,P<0.05).The results of the ROC curve showed that the AUC of CEA,NSE,ProgRP,CYFRA21⁃1 and combined detection in the diagnosis of malignant SPN were>0.70,and the predictive value was ideal.Serum CEA,NSE,ProgRP and CYFRA21⁃1 at 1 month,3 months,and 6 months after discharge were lower than those at admission,and showed a downward trend,and the difference was statistically significant(P<0.05).Conclusion Serum CEA,NSE,ProgRP and CYFRA21⁃1 are closely related to malignant lesions of SPN,and can effectively diagnose malignant SPN.